Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS5611801 A
Publication typeGrant
Application numberUS 08/346,152
Publication dateMar 18, 1997
Filing dateNov 29, 1994
Priority dateNov 29, 1994
Fee statusPaid
Publication number08346152, 346152, US 5611801 A, US 5611801A, US-A-5611801, US5611801 A, US5611801A
InventorsMatthew N. Songer
Original AssigneePioneer Laboratories, Inc.
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Method and apparatus for bone fracture fixation
US 5611801 A
Abstract
Fixation of a bone fracture may be accomplished by screw driving a threaded pin into the bone, typically in a manner to cause the pin to advance across the fracture area of the bone. It is also common for a pair or more of said pins to be driven into the bone in the manner described above. The threaded pin or pins each may have a cable secured to the pin, extending outwardly from the proximal pin end. One then wraps the cable or cables around the bone to provide external securance for fixation of the bone fracture. A pair of cables used in this process may be secured together under tension by a crimp. Otherwise, a single, free cable end may be secured to a separate pin or other anchor as desired.
Images(1)
Previous page
Next page
Claims(14)
That which is claimed is:
1. The method of fixation of a bone fracture, which comprises:
screw driving a pair of threaded pins into said bone in spaced relationship, each of said threaded pins having a cable secured to said pin and extending outwardly from the proximal pin end to a free cable end; wrapping said bone with said cables to promote fixation of said bone fracture; and securing said cable ends together.
2. The method of claim 1 in which at least one of said threaded pins crosses the fracture area to provide internal securance for fixation of said bone fracture.
3. The method of claim 1 in which the proximal pin end carries a drive fitting that permits said pin to be essentially completely advanced into said bone.
4. The method of claim 1 in which the cable of each pin extends centrally through a pin driver as the pin driver advances each pin into the bone.
5. The method of fixation of a bone fracture, which comprises:
screw driving a threaded pin into said bone in a manner to cause said pin to advance across the fracture area of the bone, to provide internal securance for fixation of said bone fracture; said threaded pin having a cable secured to said pin and extending outwardly from the proximal pin end; and wrapping said cable around said bone to provide external securance for fixation of said bone fracture.
6. The method of claim 5 in which the proximal pin end carries a drive fitting that permits said pin to be essentially completely advanced into said bone.
7. The method of claim 6 in which the cable of each pin extends centrally through a pin driver as the pin driver advances each pin into the bone.
8. The method of claim 5 in which the cable of each pin extends centrally through a pin driver as the pin driver advances each pin into the bone.
9. A device for fixation of bone fractures, which comprises: a pin defining a bone penetrating point at one end thereof and screw threads defined on said pin adjacent said point; a multistrand cable attached to said pin and extending from the end of said pin opposite said one end outwardly therefrom to an outer cable end; a polygonal driver member carried on said opposite pin end and surrounding said cable, to engage a rotary pin driver, said pin being solid and lumen-free along the majority of its length.
10. The fixation device of claim 9 having a wire leader attached to said outer cable end.
11. The fixation device of claim 10 in which said multistrand cable is made of metal.
12. The fixation device of claim 9 in which said cable is attached to said opposite pin end.
13. The method of fixation of a bone fracture, which comprises:
screw driving a threaded pin into said bone in a manner to cause said pin to advance across the fracture area of the bone, to provide internal securance for fixation of said bone fracture, and threaded pin having a cable secured to said pin and extending outwardly from the proximal pin end; and wrapping said cable around said bone to provide external securance for fixation of said bone fracture, said pin being completely advanced into said bone during said driving into the bone, said cable extending centrally through a pin driver as the pin driver advances said pin into the bone.
14. The method of claim 13 in which a pair of threaded pins are driven into said bone in spaced relationship, and including the step of wrapping said bone with said cables which extend outwardly from said proximal pin ends to promote fixation of said bone fracture; and securing said cable ends together.
Description
BACKGROUND OF THE INVENTION

Certain types of fractures of bones cannot be effectively healed without the use of a bone screw, a bone pin, a cable, or a cerclage wire, the use of all of which is known to the prior art. Also, it is been known to use a screw or a pin in combination with a cable or a cerclage wire in an attempt to provide both internal securance and external securance of a fractured bone. However, as a continuing problem, bone screws can slowly unscrew due to the normal motions of a patient during and after convalescence. This of course can cause serious problems and may require further surgery.

On the other hand, cable wrappings can slip out of their optimum position on a bone and thus lose some of their benefit.

In accordance with this invention, a bone fracture may be both internally and externally fixed, while avoiding the above described disadvantages which are found in the use of separate, threaded pins and separate cables in the fixation of bone fractures.

DESCRIPTION OF THE INVENTION

By this invention, a bone fracture may be fixated by the steps of: screw driving a threaded pin into the bone. In most cases it is desirable to cause the threaded pin to advance across the fracture area of the bone, i.e. the line of fracture, to provide internal securance for fixation of the bone fracture by the holding action which is provided by the threaded pin to the two pieces of bone separated by the fracture. By this invention, the threaded pin has a cable which is secured to the pin in typically a permanent manner, so that it cannot be separated without destroying the device. The cable extends outwardly from the proximal pin end. One then wraps the cable around the bone, typically after driving of the pin, to provide external securance for fixation of the bone fracture.

Thus, external securance and internal securance can be provided by the same fixation device. Also, added advantages are provided above and beyond the separate use of a bone pin and a separate cable, in that the tension which is applied to the threaded pin by the attached cable, and the very attachment of the cable itself, substantially prevents the unplanned unscrewing of the threaded pin after it has been implanted due to movements of the patient. At the same time, the threaded pin provides a solid anchor for the cable, so that disadvantages found in the two separate items are eliminated.

It is often desirable to screwdrive a pair of threaded pins into the bone in spaced relationship to each other, with each of the threaded pins having a cable which is secured to the pin and extending outwardly from each proximal pin end. One then wraps the bone with the cables to promote external fixation of the bone fracture, and one secures the cable ends together, typically under tension and with the use of a conventional crimp.

Here also, it is typically desirable for at least one and preferably both of the threaded pins to cross the fracture surface, to provide internal securance for fixation of the bone fracture, along with the external securance that is provided by the cables which are attached to the pins and typically are secured together after pin implantation. Preferably, a driver fitting, such as a polygonal driver member, may be carried on the proximal pin end (which is opposite to the driving point of the pin). This driver fitting may be engaged with a pin driver, preferably a pin driver in which the cable of the pin extends centrally through the pin driver, as the pin driver advances the pin into the bone. With such an arrangement, the pin driver rotates the pin and advances it until the proximal or rear end of the pin is preferably substantially flush with the surface of the bone, or even recessed. Because the tension of the cable prevents retraction of the screw threaded pin over the long term, there is no need for a retention head or the like pressing against an outer surface of the bone to prevent such undesired screw-thread rotation.

The cable pin of this invention may be used to secure fractured surfaces of bones together in a variety of situations, including the following fractures: olecranon fractures, patellar fractures, proximal humerus fractures, greater trochanteric fractures, greater tuberosity humerus fractures, femur fractures, medial malleolus tibial fractures, and calcaneus fractures, among others.

Thus, the use of a cable secured to a pin and under tension provides a double advantage: it provides the external support for a bone fracture that is needed in many instances, but it also serves to prevent unplanned withdrawal of the threaded bone pin without the need for any retention structures outside of the bone. At the same time, the bone pin serves as a solid anchor for the cable, restricting and reducing undesired slippage of the cable.

DESCRIPTION OF THE DRAWINGS

In the drawings FIG. 1 is a plan view of a bone fixation device in accordance with this invention;

FIG. 2 is a sectional view taken along line 2--2 of FIG. 1;

FIG. 3 is an end view taken along line 3--3 of FIG. 1;

FIG. 4 is an enlarged, fragmentary, transverse section showing the shape of cancellous threads, which may be the design of threads used in the pin of FIG. 1;

FIG. 5 is a perspective view showing the installation of a bone pin through a fracture surface of a bone which has suffered an olecranon fracture; and

FIG. 6 shows a subsequent step in the process of FIG. 5, with two implanted bone pins having their cables wrapped about the fractured bone and crimped together at their ends.

DESCRIPTION OF SPECIFIC EMBODIMENTS

Referring to FIGS. 1 through 4, the cable-carrying pin of this invention 10 is shown. Pin 12 is made of solid metal, typically of a body implantable alloy such as 316 L stainless steel, ASTM F-138-86; titanium alloy 6 AL-4V, ASTM F-136-92; or cobalt chrome alloy, ASTM F-90, among others. Pin 12 defines a self-tapping point 14 at one end, plus cancellous threads 16, which point and threads may be of generally conventional design for a surgical threaded pin.

The threads 16 extend about half the entire distance of pin 12, with a proximal or rear portion of pin 18 being cylindrical in shape and of less outer diameter than the threads 16, as shown. At the proximal end of pin 12, an external, hexagonal driver fitting 20 is provided, to fit with a cannulated power drill 22 for driving as illustrated in FIG. 5. Alternatively, a manual brace and bit may be used for driving the threaded pin 12 as well.

Pin 12 defines a lumen 22 extending inwardly from its proximal end a short distance, typically less than half the length of pin 12. A multi-strand wire cable 24 occupies lumen 22 and is secured therein by adhesive or by welding of some form, for example resistance welding, for a permanent attachment of an end of cable 24 to pin 12. Cable 24 may be of generally conventional design for surgical use, having a diameter of 0.04 to 0.05 inch, for example. The metals used for the multiple strand cable may be similar to the metals used to manufacture pin 12. Also, cobalt chrome, ASTM F-1091-91 may be used or titanium 6AL-4V, ASTM F-136-84.

Solid wire leader 26 is welded or otherwise permanently adhered to the end of cable 24 which is opposed to pin 12. Wire leader 26 may have a diameter of about 1 mm., typically less than the diameter of the cable, being used to facilitate the placement of the cable around the bone, making easier the penetration of the cable through narrow spaces and the like, rather in the manner of the solid end tip of a shoelace. After installation, the leader 26 and a portion of the cable 24 are typically cut away.

Pin 12 will preferably conform to ASTM standard F-543-92, entitled Standard Specifications for Cortical Bone Screws with respect to materials, threads, finish, and identification. The pin 12 may specifically have a length of 20 to 75 mm. Its larger diameter 25 of the screw threads may range from 3.5 mm. to 4.5 mm., while the minimum diameter 27 of pin 18 at the threaded portion may be 2.5 mm. to 3.5 mm. The pin tip 14 may be in the form of a diamond point, a chisel point, a trochar point, or the like.

The method of this application is illustrated in FIGS. 5 and 6. In FIG. 5, an olecranon fracture at fracture area 28 is presented. It can be seen that the relatively small bone tip 30 which has broken off with the fracture is going to be set only with substantial difficulty, since the small bone piece 30 will tend to be very mobile.

Bone pin 12 is mounted in the cannulated power drill 23, with hexagonal driver fitting 20 of the pin fitting in a female hexagonal chuck 31 or the like of power drill 23 in conventional manner. Cable 24 typically extends through the length of power drill 23 within a bore 32 so as to be out of the way and to avoid crimping of the cable. Such cannulated power drills are generally known to the art.

Then, pin 12 is driven through the bone, beginning with the small fractured portion 30, crossing fracture area 28, with all threads being spaced from area 28. Pin 12 enters deeply into the main portion 34 of the bone, so that all of pin 12 is typically sunk into the bone, with hexagonal drive fitting 20 being flush with the bone surface or even recessed. Clinical advantages are achieved through the absence of a projecting outer portion of the bone pin, without the need for a locking plate or the like to prevent back rotation of the bone pin.

FIG. 6 shows a particular surgical procedure for use of a pair of bone pins in accordance with this invention. It is to be understood that the bone pins of this invention may be used in a wide variety of surgical procedures, and not just the particular one illustrated.

As shown in FIG. 6, a pair of bone pins 12 are driven through bone portion 30, fracture area 28, and bone 34 as illustrated in FIG. 5, to provide internal securance of the fractured bone portion 30 to the rest of the bone 34. The respective cables 24 of the bone pins are then secured in the manner illustrated in FIG. 6 to provide external support of the olecranon fracture, with one of the cables 24 being shown to pass through a surgically created tunnel 36, and to then enter into engagement with the other cable 24. The cables are placed under tension, and then secured together with a tubular crimp 38 or the like in a manner which is generally conventional.

Thus, a fractured bone may be secured together, with internal securance provided by pins 12 and external securance provided by cable 24 for improved securance of difficult fractures. Back-rotation of threaded pins 12 is prevented because of their connection with the tensioned cables 24. On the other hand the cables 24 are provided with a strong and solid anchor relative to the bone to minimize cable slippage.

The above has been offered for illustrative purposes only, and is not intended to limit the scope of the invention of this application, which is as defined in the claims below.

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US2411079 *Sep 9, 1944Nov 12, 1946Baule Gerhard H JMethod of attaching sutures to shanks of surgeons' needles
US2501978 *Apr 26, 1947Mar 28, 1950Heins WichmanBone splint
US4041939 *Apr 26, 1976Aug 16, 1977Downs Surgical LimitedSurgical implant spinal screw
US4632100 *Aug 29, 1985Dec 30, 1986Marlowe E. GobleSuture anchor assembly
US4643178 *Apr 23, 1984Feb 17, 1987Fabco Medical Products, Inc.Surgical wire and method for the use thereof
US4790303 *Mar 11, 1987Dec 13, 1988Acromed CorporationApparatus and method for securing bone graft
US5037426 *Sep 19, 1988Aug 6, 1991Marlowe Goble ESurgical procedure
US5071420 *Apr 25, 1991Dec 10, 1991Depuy Du Pont OrthopaedicsIsometry testing device
US5129902 *Apr 20, 1990Jul 14, 1992Marlowe Goble EEndosteal ligament retainer and process
US5141520 *Oct 29, 1991Aug 25, 1992Marlowe Goble EHarpoon suture anchor
US5152790 *Mar 21, 1991Oct 6, 1992American Cyanamid CompanyLigament reconstruction graft anchor apparatus
US5156616 *Feb 10, 1992Oct 20, 1992Meadows Bruce FCannulated bone screw for anchoring a suture thread to bone
US5318566 *Jun 22, 1992Jun 7, 1994Danek Medical, Inc.Sternotomy cable and method
US5474554 *Jul 27, 1994Dec 12, 1995Ku; Ming-ChouMethod for fixation of avulsion fracture
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US5797916 *Dec 10, 1996Aug 25, 1998Johnson & Johnson Professional, Inc.Trochanteric reattachment cerclage device
US5964765 *Apr 16, 1998Oct 12, 1999Axya Medical, Inc.Soft tissue fixation device
US6099527 *Apr 30, 1998Aug 8, 2000Spinal Concepts, Inc.Bone protector and method
US6248106Feb 25, 2000Jun 19, 2001Bret FerreeCross-coupled vertebral stabilizers
US6270501Nov 8, 1999Aug 7, 2001The Regents Of The University Of MichiganSurgical method and apparatus and cannulated scalpel for use therein
US6368326 *Sep 28, 1998Apr 9, 2002Daos LimitedInternal cord fixation device
US6409743Jul 8, 1999Jun 25, 2002Axya Medical, Inc.Devices and methods for securing sutures and ligatures without knots
US6423065Apr 24, 2001Jul 23, 2002Bret A. FerreeCross-coupled vertebral stabilizers including cam-operated cable connectors
US6423088Jun 30, 2000Jul 23, 2002Axya Medical, Inc.Sharp edged device for closing wounds without knots
US6648903Sep 8, 1998Nov 18, 2003Pierson, Iii Raymond H.Medical tensioning system
US6689140Oct 1, 2001Feb 10, 2004Howmedica Osteonics Corp.System and method for spinal reconstruction
US6730092Dec 3, 2001May 4, 2004Pioneer Laboratories, Inc.System and method for bone fixation
US7090675Mar 25, 2004Aug 15, 2006Pioneer Laboratories, Inc.System and method for bone fixation
US7131973 *May 16, 2002Nov 7, 2006Boston Scientific Scimed, Inc.Bone anchor implantation device
US7229441 *Feb 26, 2002Jun 12, 2007Warsaw Orthopedic, Inc.Flexible systems for spinal stabilization and fixation
US7285121 *May 2, 2002Oct 23, 2007Warsaw Orthopedic, Inc.Devices and methods for the correction and treatment of spinal deformities
US7344539Mar 30, 2001Mar 18, 2008Depuy Acromed, Inc.Intervertebral connection system
US7410489Jul 29, 2003Aug 12, 2008Daos LimitedInternal cord fixation device
US7591823 *Feb 17, 2004Sep 22, 2009Lagwire, LlcSystem and method for the fixation of bone fractures
US7758614 *Apr 5, 2002Jul 20, 2010Tornier, Inc.Coupling member for knotless sutures and ligatures
US7766941May 14, 2004Aug 3, 2010Paul Kamaljit SSpinal support, stabilization
US7833225 *Apr 23, 2004Nov 16, 2010Orthohelix Surgical Designs, Inc.Method and device for bone stabilization using a threaded compression wire
US7837717Mar 24, 2006Nov 23, 2010Depuy Products, Inc.Fastening system for internal fixation
US8021425 *Jul 21, 2009Sep 20, 2011Intrinsic Therapeutics, Inc.Versatile method of repairing an intervertebral disc
US8105384Jun 29, 2009Jan 31, 2012Intrinsic Therapeutics, Inc.Weakened anulus repair
US8267943Feb 12, 2008Sep 18, 2012Anova CorporationMethods and devices for bone, joint, and ligament reconstruction with bands
US8277459 *Sep 25, 2009Oct 2, 2012Tarsus Medical Inc.Methods and devices for treating a structural bone and joint deformity
US8337528Nov 27, 2007Dec 25, 2012Anova CorporationMethods and apparatus for stabilizing a spinal segment
US8337529Feb 12, 2008Dec 25, 2012Anova Corp.Methods of bone, joint, and ligament reconstruction
US8597300Nov 22, 2010Dec 3, 2013Biomet, C.V.Fastening system for internal fixation
US8652141Jan 21, 2010Feb 18, 2014Tarsus Medical Inc.Methods and devices for treating hallux valgus
US8679167Feb 23, 2007Mar 25, 2014Orthoip, LlcSystem and method for a cap used in the fixation of bone fractures
US8696719Jun 3, 2010Apr 15, 2014Tarsus Medical Inc.Methods and devices for treating hallux valgus
US8702768Apr 30, 2007Apr 22, 2014Orthoip, LlcCannulated bone screw system and method
US8795286Sep 6, 2012Aug 5, 2014Tarsus Medical Inc.Methods and devices for treating a structural bone and joint deformity
US8828067Dec 7, 2007Sep 9, 2014Orthoip, LlcBone screw system and method
US8870876Feb 13, 2009Oct 28, 2014Tarsus Medical Inc.Methods and devices for treating hallux valgus
US20100094348 *Aug 31, 2009Apr 15, 2010Lutz BiedermannBone anchoring element and stabilization device for bones, in particular for the spinal column
US20110077656 *Sep 25, 2009Mar 31, 2011Sand Paul MMethods and devices for treating a structural bone and joint deformity
US20110295252 *May 31, 2011Dec 1, 2011Orthoip, LlcLagwire system and method for the fixation of bone fractures
US20120316608 *Jun 8, 2011Dec 13, 2012Warsaw Orthopedic, Inc.Flexible guide wire
EP1683501A1Jan 10, 2006Jul 26, 2006Groupe LepineDevice for the osteosynthesis of a shoulder joint
WO2000013601A1 *Sep 8, 1999Mar 16, 2000Raymond H Pierson IiiMedical tensioning system
Classifications
U.S. Classification606/308, 606/74, 606/104, 606/103, 606/311
International ClassificationA61B17/88, A61B17/82
Cooperative ClassificationA61B17/82, A61B17/8875
European ClassificationA61B17/88S, A61B17/82
Legal Events
DateCodeEventDescription
Jul 29, 2013ASAssignment
Owner name: TD BANK, N.A., AS ADMINISTRATIVE AGENT, FLORIDA
Free format text: SECURITY AGREEMENT;ASSIGNOR:PIONEER SURGICAL TECHNOLOGY, INC.;REEL/FRAME:030892/0193
Effective date: 20130716
Jul 19, 2013ASAssignment
Free format text: RELEASE BY SECURED PARTY;ASSIGNOR:JPMORGAN CHASE BANK, N.A., A SUCCESSOR BY MERGER TO NBD BANK;REEL/FRAME:030840/0073
Effective date: 20130716
Owner name: PIONEER SURGICAL TECHNOLOGY, INC. FORMERLY KNOWN A
Sep 18, 2008FPAYFee payment
Year of fee payment: 12
Nov 14, 2007ASAssignment
Owner name: PIONEER SURGICAL TECHNOLOGY, INC., MICHIGAN
Free format text: CHANGE OF NAME;ASSIGNOR:PIONEER LABORATORIES, INC.;REEL/FRAME:020105/0308
Effective date: 20061211
Free format text: CHANGE OF NAME;ASSIGNOR:PIONEER LABORATORIES, INC.;REEL/FRAME:20105/308
Owner name: PIONEER SURGICAL TECHNOLOGY, INC.,MICHIGAN
Aug 5, 2004FPAYFee payment
Year of fee payment: 8
Sep 8, 2000FPAYFee payment
Year of fee payment: 4
Jul 9, 1997ASAssignment
Owner name: NED BANK, MICHIGAN
Free format text: SECURITY INTEREST;ASSIGNOR:PIONEER LABORATORIES, INC.;REEL/FRAME:008587/0745
Effective date: 19970620
May 6, 1996ASAssignment
Owner name: PIONEER LABORATORIES, INC., MICHIGAN
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:SONGER, MATTHEW N.;REEL/FRAME:007925/0085
Effective date: 19941114